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   Table of Contents - Current issue
Coverpage
January-June 2021
Volume 12 | Issue 1
Page Nos. 1-38

Online since Monday, August 9, 2021

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REVIEW ARTICLE  

Laboratory diagnostic phases of detection of SARS-CoV-2 by real-time reverse transcription-polymerase chain reaction p. 1
Mohammed Ibrahim Tahir, Abdurrahman El-Fulaty Ahmad, Yahaya Usman, Aliyu Muhammad, Temidayo Oluwafemi Ige, Olanrewaju Jimoh, Shamsudin Aliyu, Auwal Usman, Mustapha Umar Imam, Zainab Lamido Tanko, Emmanuel Balogun, Ahmed Babangida Suleiman
DOI:10.4103/atp.atp_49_20  
The emergence of coronavirus disease 2019 (COVID-19) has caused global health concerns in the various strata of health-care authorities. The detection of the etiologic agent, SARS-CoV-2 became essential for case identification and prevention of transmission. In this review, literature was retrieved and sifted from different search engines. We highlighted some mainstream pointers vis-à -vis preanalytical, analytical, and postanalytical phases of laboratory detection of SARS-CoV-2 using real-time reverse transcription-polymerase chain reaction (RT-PCR) assay. The quantitative RT-PCR is considered as the gold standard for establishing the diagnosis of COVID-19. However, laboratories must pay attention to all the testing phases from sample collection to final release of results in order to avoid false-negative or false-positive results. It is also necessary to understand possible challenges and conduct risk assessment before the commencement of testing in the designated laboratory.
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ORIGINAL ARTICLES Top

Distribution and clinicopathologic characteristics of squamous cell carcinoma of the skin: An analysis of 100 cases p. 9
Said Mohammed Amin, Aisha Nabila Ado Wanka, Laila Ahmed Sabir, Edith Hamsatu Terna-Yawe, Eunice Ojoyi Onuh
DOI:10.4103/atp.atp_53_20  
Background: The World Health Organization estimates that 2–3 million nonmelanocytic skin cancers occur annually worldwide and cutaneous squamous cell carcinoma (cSCC) is the most common of these tumors. This study analyzes the clinicopathological characteristics of SCC of the skin and the demographic profiles of the affected patients. Materials and Methods: A retrospective review of dermatological malignancies from January 2004 to December 2019 in the Department of Histopathology, National Hospital Abuja, was conducted. Data were exported from the department software in comma-separated value format and demographic and other clinicopathological characteristics were analyzed as categorical variables. Descriptive and inferential statistics, bi-variate correlation (Spearman ranking), and binary logistic regression analysis were applied between demographic variables: age and sex as independent variables, and clinicopathological variables: clinical presentation, anatomical site, and histological types. P ≤ 0.05 is considered as statistically significant. Results: A total of 103 cases of cSCC were histologically confirmed during the study period, and these accounted for 25.8% of the dermatological malignancies within the period of the study. There were 59 (57.3%) males and 44 (42.7%) female patients with a male to female ratio 1.3:1. The mean age of the study participant was 35.9 ± 13 and the age range 4–81 years. The peak age incidence was within the third to fourth decade of life accounting for 69 (66.9%). Conclusion: cSCC was predominant in the head and neck region. Age was found to be a significant factor (P < 0.05), patients <50 years were 8 fold likely to develop SCC of the head and neck region (odds ratio = 7.731, 95% confidence interval = 1.257–47.560). Early preventive measures, early presentation, and proper evaluation could improve the outcome of SCC.
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Assessment of Nigerian blood transfusion centers' capacity for provision of convalescent plasma for treatment of SARS-CoV-2 infected patients p. 14
Ibrahim Musa Idris, Abdulwahab Ibrahim Baba, Kazeem Kayode Owolabi, Aisha Kuliya-Gwarzo
DOI:10.4103/atp.atp_56_20  
Background and Objectives: With the data from small clinical trials leading to the emergency authorization of convalescent plasma (CP) as one of the treatment options of coronavirus disease 2019 (COVID-19) in the United States, countries across the world are likely to key in as the race toward discovering evidence-based treatment and vaccines continues. We assessed Nigerian blood transfusion services' preparedness to provide CP support for patients with moderate-to-severe acute respiratory syndrome coronavirus 2 infection. Materials and Methods: We conducted an online survey using a questionnaire designed to assess the Nigerian blood centers' existing capacity. Forty-two tertiary facilities were selected, and a questionnaire was E-mailed to the selected blood bank staff of each center. Responses were collated and analyzed using descriptive statistics. Results: The majority of the facilities had neither apheresis (73.5% [25 of 34]) nor cold centrifuge (55.9% [19 of 34]) for blood components collection or preparations. Family replacement blood donors contributed 51%–90% of the donations in 70.6% (24 of 34) of the centers. Only 2.9% of the centers had an existing capacity for using nucleic acid to screen transfusion transmissible infections, and only one center reported the capacity for pathogen inactivation of blood components. None of the centers provide leukodepletion for blood components. Conclusion: At the current state, Nigerian blood transfusion services are incapable of providing adequate and safe CP for COVID-19 treatment. Efforts should be made to invest in this critical health service area to take advantage of the readily available CP to reduce mortality and morbidity associated with the COVID-19 pandemic, and other disorders.
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Diagnostic utility of immunochemical technique using p63 and Alpha Methylacyl Coenzyme A Racemase (AMACR) in the diagnosis of core-needle biopsy of the prostate: Experience in a tertiary academic institution in Nigeria p. 19
Damian Ikechukwu Okonkwo, Solomon Raphael, Charles Chidozie Anunobi, Paul Gowon Jibrin
DOI:10.4103/atp.atp_44_20  
Background: Prostate adenocarcinoma is one of the most common malignancies and a leading cause of cancer-related mortality among males worldwide. There are challenges associated with confident/equivocal diagnosis of prostate carcinoma on small prostate samples from core-needle biopsies diagnosed histologically because of certain mimickers of prostatic carcinoma. Hence, there is a need to improve the diagnostic accuracy of the histological diagnosis of core-needle biopsies by utilizing immunohistochemical profiling to overcome these challenges. The aim of this study was to use p63 and alpha-methylacyl coenzyme A racemase (AMACR) immunostains to confirm hematoxylin and eosin (H and E) diagnosed adenocarcinomas and clarify equivocal diagnoses as well as correlate the H and E diagnoses with immunohistochemical diagnoses. Materials and Methods: This was a 3-year retrospective study of core-needle prostatic biopsies processed at the Anatomic and Molecular Pathology Department of Lagos University Teaching Hospital, Lagos, Nigeria. The formalin-fixed paraffin-embedded tissue blocks were retrieved, and new slides were prepared in cases where old slides were faded. The routinely processed slides were reviewed and classified into the following categories: benign, malignant (adenocarcinoma), and equivocal lesions (i.e., lesions considered suspicious for adenocarcinoma). The cases diagnosed as adenocarcinoma and equivocal lesions were then subjected to immunohistochemistry (IHC) using p63 and AMACR monoclonal antibodies to confirm the diagnoses of prostate adenocarcinoma and clarify the equivocal diagnoses. Based on the findings on IHC, the cases were reclassified as either adenocarcinoma, benign or indeterminate lesions (i.e., lesions that could not be classified as either benign or adenocarcinoma due to poor staining quality). Results: A total of 221 prostatic core biopsies met the inclusion criteria for this study. Out of these, histological diagnoses of prostatic adenocarcinoma were made in 113 cases (51.1%), 86 cases (38.9%) were benign, while equivocal cases accounted for 22 cases (10%). The result showed that out of 113 H and E diagnosed prostatic carcinoma that were subjected to p63 and AMACR stains, 101 (89.4%) of them were found to be truly adenocarcinoma, while 7 (6.2%) were benign and 5 cases (4.4%) were indeterminate lesions. The results of p63 and AMACR on the 22 histologically diagnosed equivocal prostatic lesions showed that 13 (59.1%) of the cases were adenocarcinoma, 7 cases (31.8%) were benign while 2 cases (9.1%) were indeterminate lesions. These p63 and AMACR immunostain results on routinely diagnosed prostatic carcinoma and equivocal diagnoses showed a statistically significant difference in the diagnostic potential of p63 and AMACR IHC when compared to the H and E as a diagnostic tool (P ≤ 0.001). Conclusion: We conclude that although histopathological examination of H and E sections remains the gold standard in the diagnosis of prostatic adenocarcinoma, the adjunctive use of p63 and AMACR immunostains is of great value in confirming small foci of adenocarcinoma, resolving morphologically equivocal cases and excluding benign mimickers as confounder in the diagnosis prostatic adenocarcinoma in small prostate samples obtained by core-needle biopsy.
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Evaluation of histopathology request forms from major institutions in Nigeria and a proposal for a prostate disease-specific histopathology request form p. 26
Ademola Alabi Popoola, Kayode A Adeniji, Tolulope Taiwo Ogunfowora, Hamid Babajide Olanipekun, Arinze M Egbuniwe, Peter O Odeyemi, Toluwanimi J Ademola Popoola
DOI:10.4103/atp.atp_58_20  
Introduction: Histopathology Request Forms (HRFs) serve as interphase between clinicians and pathologists in making diagnosis of tissue pathology. Inadequacies of the completion of HRFs have been a source of major frictions between the two groups of physicians. Various reports have highlighted this inadequacy. The need for adequate information on the HRF to be standardized cannot be overemphasized. Aim: The paper aims to evaluate the histopathology request forms from institutions in Nigeria and to propose an improved prostate disease-specific histopathology request form. Methodology: Histopathological request forms from some major Nigerian health institutions were analyzed for adequacy based on required information for a standardized histological reportage. A request form specific for suspected prostate diseases was designed from the review of literature. Results: Histopathology request forms (HRFs) from sixteen Nigerian health institutions were received from all the geopolitical zones of the country following a request. All the HRFs were neither organ nor disease specific. None of the HRFs was adjudged to be satisfactory to produce enough information adequate for comprehensive histopathology reportage. A prostate disease-specific histological request form is proposed following review of literature. Discussion: The need for a comprehensive prostate-specific HRF cannot be overemphasized to improve the relationships between surgeons and pathologists and to improve reportage of prostate pathologies and the management of prostatic diseases. Conclusion: Adequate clinical information is needed for early and complete reportage of histopathological report of prostate diseases.
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CASE REPORTS Top

Renal cell carcinoma arising within autosomal dominant polycystic kidney disease p. 32
Muzammil Abdullahi, Anas Ismail, Abdullahi Ahmad
DOI:10.4103/atp.atp_54_20  
Renal cell carcinoma (RCC) arising within autosomal dominant polycystic kidney disease (ADPKD) is rare. The detection of this complication in patients with ADPKD is difficult owing to the nonspecific symptoms. Here, we describe a case of a young woman who presented with RCC in the background of ADPKD. She had radical nephrectomy, followed by adjuvant chemotherapy.
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Columnar cell variant of papillary carcinoma of the thyroid gland in a 22-year-old African female p. 35
Yemisi Oluseyi Kila Uvie-Emegbo, John Olufemi Ogunbiyi, Nasir Akanmu Ibrahim, Sa'eid Funsho Ahmad
DOI:10.4103/atp.atp_51_20  
Columnar cell variant of papillary carcinoma of the thyroid gland is a rare and aggressive thyroid malignancy with the clinical course predicated on the clinical stage, with the presence or absence of extrathyroid invasion. The tumors tend to occur in the elderly. We herein report a case of columnar cell variant of papillary carcinoma of the thyroid gland with lymph node metastasis in a 22-year-old African female who presented with 2 years' history of anterior neck swelling. The clinical examination, imaging, and cytological examination were suggestive of a benign neoplasm. An initial subtotal thyroidectomy was histologically diagnosed to be a columnar variant of papillary carcinoma. She subsequently had a completion thyroidectomy with resection of residual malignant thyroid tissue and lymph node, which showed metastasis. The patient is on follow-up.
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